Individual
MICK MBANZA MUSENGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 BRYAN PL SE, WASHINGTON, DC 20020-4417
(202) 894-6811
Mailing address
19021 GALLOP DR, GERMANTOWN, MD 20874-6145
(301) 204-5801
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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